‘The Solution’ to Weight Loss: (Part 1)

In real life, salvation doesn’t usually debut as tidily as it does in the movies. You know, when the heroine peeks in the rearview mirror or glances up at a billboard, and there it is in fiery script: the magic combination that will make her life work.

But that’s how it seemed when Sally Shreve’s phone rang one morning last winter. Shreve’s friend, Sue Ann DeBower, was on the line, exclaiming over a book that promised deliverance from the weight problems that had bedeviled both women for years. “It’s us all over these pages,” she enthused. “This is the key, finally.”

DeBower wasn’t talking about a new diet, a pill with scary side effects, or a grinding exercise regimen. No, The Solution, the program described in the book of the same name, claimed that to lose weight a person merely need to pause five times each day and ask herself two elementary questions: “How am I feeling?” and “What do I need?”

There was a little more to it. After noting the feelings, she’d have to practice ways of coping with them. And she’d have to adopt some healthy eating and exercise patterns as well. But the crucial steps were so simple a child could follow them. In fact, the program was originally developed for overweight children.

Then a 45-year-old sales executive for a high-tech company, Shreve had tried repeatedly to lose and keep off the 40 extra pounds that had dogged her most of her adult life. Despite her best efforts to eat right and exercise, the weight always came back. Part of the reason may have been genetic; other members of her family had struggled with excess pounds. But she knew she sometimes ate to buffer herself from emotions she’d rather not face. So the Solution made intuitive sense to her.

Still, when the blinding light appears in the rearview mirror, some people turn away. “No way,” Shreve told her friend. “I am not going where this book wants me to go. If I do what the book says, I’m going to start crying and never stop.”

Growing up emotionally

The Solution, a program available at more than 100 hospitals nationwide, is based on the idea that to lose weight people need to grow up. Or, to put it more gently, they must brush up on skills they should have learned as children, such as the ability to comfort themselves when they feel sad or afraid and to set limits on their behavior. Solution founder Laurel Mellin believes people who lack these abilities tend to soothe themselves by eating more than they need. When they are able to master other ways of nurturing themselves, the drive to overeat gets turned off, says Mellin, a dietitian who teaches community medicine and pediatrics at the University of California at San Francisco School of Medicine.

Sounds good. But weight-loss claims are as plentiful as “Seinfeld” reruns. What makes Mellin’s concept any more promising than all the others? For one thing, Mellin didn’t just materialize on the scene. She has 18 years of experience directing a well-regarded child and adolescent program, Shapedown. This plan, which inspired The Solution, is used in some 400 hospitals around the country and has been shown to help heavy kids lose weight and keep it off.

Mellin published a pilot study in the Journal of the American Dietetic Association suggesting that Shapedown techniques work for adults as well. Twenty-two adults who completed a Solution course had, on average, kept off 17 pounds two years later. What’s more, the participants were exercising an average of three hours more per week than before they enrolled, and 69 percent had sustained a substantial decrease in their blood pressure.

What’s most important among these findings, Mellin says, is that the weight stays off long after the lessons are done. In fact, she claims, “This is the first time that a weight-loss treatment has shown long-term maintenance well after the treatment ends.”

To today’s weary dieters, this would appear to be delicious news. Since the 1970s, obesity rates climbed from about 20 percent to nearly 35 percent, and a record 68.8 percent of America’s adults now overweight. And the standard remedies are of little use. A landmark National Institutes of Health report confirmed what countless women already knew: Diets don’t work, because people almost always regain the weight they lost.

Into this tableau strolls Laurel Mellin, clutching her small study and a fervent belief that when people learn to look within, they can subdue the urge to overeat. Her approach borrows from existing weight-loss programs and makes use of the common psychological techniques. The Solution group carries a hint of cognitive therapy (which attempts to uncover and change self-defeating ways of thinking) and dollops of behavioral therapy (which reinforces good habits with rewards). It even weaves in the most venerable strategies of all: eating right and exercising.

But Mellin says none of these traditional approaches alone is enough. That’s why the bedrock of her plan is teaching students how to identify their feelings and fulfill their needs by means other than eating. If you automatically head for the refrigerator when you’re feeling lonely and blue, for instance, you might try visiting a friend or writing a letter instead. If you overeat when work becomes stressful, you could instead schedule a special treat for yourself, like a day spa or a long walk in the country.

For people who make such choices naturally, it’s unfathomable that fully functioning adults would have to take a class to discover their feelings and find ways to act on them. But for Mellin’s students, mastering these abilities can feel as foreign as learning to drive on the left side on the road.

This emphasis on feelings is what sets The Solution apart from most weight-loss programs today. But it’s not brand new. Mellin is actually reviving a concept that was popular several decades ago.

Emotional eating

As she studied the topic of childhood obesity, she kept returning to an idea posited by psychiatrist Hilde Bruch and other researchers in the 1940s and 1950s. These theorists believed that some overweight people were unable to accurately read and respond to their own emotions, interpreting all troubling feelings as hunger and trying to assuage them by eating.

The concept lost favor as evidence for a genetic basis to excess weight piled up. And some critics felt that Bruch’s approach unfairly stigmatized overweight people by suggesting they were somehow deficient. But when Mellin unearthed the older theories, she knew from her own experience they made sense; as a teenager she’d sought solace in sweets. The stigma argument didn’t stop her from pursuing Bruch’s hypothesis. Lots of people lacked self-nurturing and limit-setting skills as far as she could see — skinny people as well as fat. It would be a service to educate them.

See part II


Interview with Sally Shreve, participant, The Solution

Interview with Laurel Mellin, founder, The Solution

Centers for Disease Control and Prevention. Obesity and Overweight. http://www.cdc.gov/obesity/index.html

© HealthDay

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